Individual
TRACEY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.,QMHP-C
Contact information
Practice address
212 N UNION ST, DANVILLE, VA 24541-1030
(276) 732-9195
Mailing address
543 COLONIAL DR, COLLINSVILLE, VA 24078-1105
(276) 732-9195
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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